ATHEROSCLEROTIC DISEASE IN THE FEMORAL-ARTERY IN HYPERTENSIVE PATIENTS AT HIGH CARDIOVASCULAR RISK - THE VALUE OF ULTRASONOGRAPHIC ASSESSMENT OF INTIMA-MEDIA THICKNESS AND PLAQUE OCCURRENCE

The aim of the present investigation was to examine the occurrence of ultrasound-assessed morphological changes in the right common femoral artery and relate these findings to the ankle-arm index and to symptom s of lower-extremity arterial disease in hypertensive men at high card iovascular risk (n=143). Comparisons were made with a healthy referenc e group consisting of age-matched men at low risk (n=46). The results showed that it was possible to obtain high-quality measurements of int ima-media thickness in about 80% of all men and that the intraobserver variability was satisfactory (14%). A normal mean intima-media thickn ess was defined, using data from the low-risk group. Plaque occurrence and mean intima-media thickness in the right common femoral artery we re significantly associated with ankle-arm index both in the right and left leg. There were more and larger plaques, as well as thicker mean and maximum intima-media complexes, in the high-risk group than in th e low-risk group. In the high-risk group, 11% suffered from symptoms o f right lower-extremity artery disease, 20% had an ankle-arm index les s than or equal to 0.9, 62% had moderate or large plaques (compared wi th 28% in the low-risk group, P<.001), and 77% had an enlarged intima- media complex. The cumulative frequency of signs of atherosclerosis in the right leg was 81% among the 110 patients in whom complete results from all examinations were available. Our conclusion is that ultrasou nd measurement of the intima-media thickness of the common femoral art ery is a valuable method to evaluate morphological changes related to atherosclerotic disease in the lower extremity.